获得性糖皮质激素抵抗:同源糖皮质激素受体下调导致的古老问题的现代研究。
Acquired Glucocorticoid Resistance Due to Homologous Glucocorticoid Receptor Downregulation: A Modern Look at an Age-Old Problem.
机构信息
Department of Biochemistry, Stellenbosch University, Van de Byl Street, Stellenbosch 7200, South Africa.
出版信息
Cells. 2021 Sep 24;10(10):2529. doi: 10.3390/cells10102529.
For over 70 years, the unique anti-inflammatory properties of glucocorticoids (GCs), which mediate their effects via the ligand-activated transcription factor, the glucocorticoid receptor alpha (GRα), have allowed for the use of these steroid hormones in the treatment of various autoimmune and inflammatory-linked diseases. However, aside from the onset of severe side-effects, chronic GC therapy often leads to the ligand-mediated downregulation of the GRα which, in turn, leads to a decrease in GC sensitivity, and effectively, the development of acquired GC resistance. Although the ligand-mediated downregulation of GRα is well documented, the precise factors which influence this process are not well understood and, thus, the development of an acquired GC resistance presents an ever-increasing challenge to the pharmaceutical industry. Recently, however, studies have correlated the dimerization status of the GRα with its ligand-mediated downregulation. Therefore, the current review will be discussing the major role-players in the homologous downregulation of the GRα pool, with a specific focus on previously reported GC-mediated reductions in GRα mRNA and protein levels, the molecular mechanisms through which the GRα functional pool is maintained and the possible impact of receptor conformation on GC-mediated GRα downregulation.
七十多年来,糖皮质激素(GCs)的独特抗炎特性通过配体激活的转录因子——糖皮质激素受体 α(GRα)发挥作用,使这些甾体激素能够用于治疗各种自身免疫和炎症相关疾病。然而,除了严重副作用的出现外,慢性 GC 治疗常常导致配体介导的 GRα下调,这反过来又导致 GC 敏感性降低,实际上就是获得性 GC 抵抗的发展。尽管配体介导的 GRα下调已有相关记载,但影响这一过程的确切因素尚不清楚,因此,获得性 GC 抵抗的发展对制药行业来说是一个日益严峻的挑战。然而,最近的研究将 GRα 的二聚化状态与其配体介导的下调相关联。因此,本综述将讨论影响 GRα 池同源下调的主要因素,特别关注先前报道的 GC 介导的 GRα mRNA 和蛋白水平降低、维持 GRα 功能池的分子机制以及受体构象对 GC 介导的 GRα 下调的可能影响。